Graduate Certificate Application

Application Details

Certificate

Start date

Are you currently licensed as a healthcare provider?

Your application may require additional consideration for admission to the program.

Are you currently enrolled in one of the following programs at Drake University?

Doctor of Pharmacy
Master of Athletic Training
Occupational Therapy Doctorate

Are you currently enrolled in a Doctor of Pharmacy program outside of Drake University?

Are you currently enrolled in a Doctor of Psychology program outside of Drake University?

Personal Information

First name

Middle name

Last name

Preferred first name (if different from above)

Other name(s) that may appear on supporting documents (e.g., maiden name)

Pronouns

Date of birth

Gender

Are you Hispanic or Latino?

Please check all that apply.

Primary citizenship

Secondary citizenship (if applicable)

Are you a U.S. permanent resident?

Are you an international student?

If you are planning to complete this program while outside the U.S., you are welcome to apply. However, if you are planning to complete this program while in the U.S., please be advised that some non-immigrant visas (e.g., the F-1 student visa) restrict enrollment in online courses. Please contact Dianna Gray at dianna.gray@drake.edu or 1-515-200-5282 if you have any questions about your eligibility to enroll in this program.

Current visa

Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Same as Mailing Address

Country

Street

City

Region

Postal Code

Phone

Academic Information

Please list all undergraduate or graduate schools previously or currently attended.

DeleteSchool _ID_
School CEEB Country City Region Postal Code Attended from Attended from Attended to Attended to Level of study Degree (earned or anticipated) Degree (earned or anticipated) Degree date (actual or anticipated) Degree date (actual or anticipated)

Add School

Healthcare Provider License

Please upload a current copy of your healthcare provider license.

Resume or Curriculum Vitae

Please upload a current copy of your resume or curriculum vitae.

Transcripts

To expedite the review of your application, you may upload transcripts from all colleges and universities previously attended below. Otherwise, please arrange for each institution to send an official transcript to Drake at:

Drake University
Office of Admission
2507 University Ave
Des Moines, IA 50311
drakeonline@drake.edu

Note: If you are admitted with unofficial or in-progress transcripts, you will be required to submit official final transcripts within 30 days of starting classes.

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